Lambert H J, Friesen H
Nsambya Hospital, Kampala, Uganda.
Ann Trop Paediatr. 1989 Mar;9(1):1-5. doi: 10.1080/02724936.1989.11748587.
A total of 177 children seen at two hospitals in Kampala are described who were strongly suspected of having acquired immunodeficiency syndrome (AIDS), either on clinical grounds or because they fulfilled the World Health Organization (WHO) case-definition criteria for diagnosis of paediatric AIDS. Blood was taken from the 177 children and 154 of their mothers and tested for antibody to human immunodeficiency virus (HIV) by an enzyme-linked immunoassay (ELISA). Altogether, 119 (67%) children were seropositive, but only 85 (71%) fulfilled the WHO case-definition criteria, and they were significantly older than the 34 who did not fulfil the criteria. A further 58 children were seronegative but fulfilled the WHO criteria. Of the 119 seropositive children, only 3 had a history of previous blood transfusion, but 103 (98%) of 105 mothers were HIV seropositive: consequently, their children were considered to have been infected in utero or perinatally. Thirteen (26%) of 49 mothers of seronegative children were seropositive. Eighty per cent of HIV-infected children were under 2 years of age at diagnosis and 23% died within 3 months of diagnosis. None of the parents was known to be an intravenous drug user, a prostitute or bisexual. The difficulty of accurate diagnosis of AIDS presents a major problem in Africa, as the WHO clinical case-definition criteria alone are clearly not adequate.
本文描述了在坎帕拉两家医院就诊的177名儿童，这些儿童因临床症状或符合世界卫生组织（WHO）小儿艾滋病诊断病例定义标准而被高度怀疑感染了获得性免疫缺陷综合征（AIDS）。采集了这177名儿童及其154名母亲的血液，采用酶联免疫吸附测定（ELISA）检测人类免疫缺陷病毒（HIV）抗体。共有119名（67%）儿童血清呈阳性，但只有85名（71%）符合WHO病例定义标准，且他们的年龄显著大于不符合标准的34名儿童。另有58名儿童血清呈阴性，但符合WHO标准。在119名血清呈阳性的儿童中，只有3名有输血史，但105名母亲中有103名（98%）HIV血清呈阳性，因此他们的孩子被认为是在子宫内或围产期感染的。血清呈阴性儿童的49名母亲中有13名（26%）血清呈阳性。80%的HIV感染儿童在诊断时年龄小于2岁，23%在诊断后3个月内死亡。已知父母中没有静脉吸毒者、妓女或双性恋者。在非洲，准确诊断艾滋病存在困难，因为仅靠WHO临床病例定义标准显然是不够的。
